Join BWC – Business Women's Connection

Please read the membership information carefully before submitting this application. Please fill out the application completely and press submit at the bottom to send it. You will be asked to sign your application at your first meeting. Or you can download a pdf that you can fill in on your computer and print to bring to a meeting. You can also request an application at your first visit.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone
Email
Website
Service or product to be promoted through The Business Women's Connection:*
(please describe in detail)
Is your profession licensed by any organization?*
- Yes
- No
If so, are you licensed?*
- Yes
- No
- N/A
Other services or products which might overlap with yours, causing a conflict of exclusivity:
Do you anticipate any difficulty with our attendance requirements?*
- No
- Yes (please explain below)
Potential attendance difficulties
Business Address (if different from home address)
Street Address Address Line 2 City State ZIP Code
Do you belong to any other networking groups or leads clubs in which exclusive representation of product or service is a benefit of membership?*
- Yes
- No
Comments
This field is for validation purposes and should be left unchanged.